Summary of MINUTES
CANS Board of Directors Meeting
Saturday, September 6, 2003,Hilton Oakland Airport, California



1.    Survey

The Board approved the distribution of a survey on ER coverage that was proposed by CANS member, Dr. Scott Lederhaus.  The survey is to be sent as soon as possible to both members and non-members.

2.    CSNS Meeting
The fall meeting will be represented by Drs. Wade and Zusman. Dr. Rich reviewed the 2 resolutions that will be presented at the October meeting of the Council of State Neurosurgical Societies (CSNS) and were previously approved by the Board:
a.         Proposed CME Requirements by ABNS
This resolution requests that CSNS strongly recommend that the ABNS recognize any CME Category I
educational material that meets AMA Guidelines.  The ABNS plans to designate what is to be
considered “neurosurgery related” and this may likely be only AANS-sponsored.
b.         CNS Bylaws Revision Article V, Section Nominations for Office 
This resolution was written because the CNS has proposed a bylaws change stating that no one is eligible to be a CNS officer unless that person has served on the Executive Committee for at least 3 years. Since the CNS Nominating Committee is appointed by the Board, there are essentially no checks and balances to ensure an equitable selection of potential officers nor could CNS members nominate potential officers by petition.  Dr. Smith reported that this resolution has already passed by electronic vote. Only one of the CANS Board members and consultants present stated that he had received an electronic ballot.  Dr. Rich will write to the CNS to notify them of the situation.

3.         AANS Nominations
Dr. Rich asked the Board to review the nomination letter that will be sent to the AANS for 2004 officers. Nominations are for Charles Hodge, M.D. for Vice President and David Jimenez, M.D. and Troy Tippett, M.D. for Directors-at-Large.  These nominations had previously been approved by the CANS Board.

4.         Membership
Dr. Bonner reported that a recruitment package was recently sent to approximately 200 non-members.
Two new members were approved for membership: Nalin Gupta, M.D. and Sandeep Kunwar, M.D., 
both of Stanford.  Dr. Frank Smith has asked to resign from CANS due to illness, but the Board 
agreed to decline his resignation and to bestow Honorary Membership upon Dr. Smith.  A letter 
requesting nominations for candidates for 2004 will be sent to the membership in about a month since 
the slate is due to the CANS Secretary by November 1, 2003 .

5.         Treasurer's Report 
Dr. Wade reported that the CANS monthly operating income and expenses are stable. The budget is 
in line as expected, although delinquent dues are still being collected.  Annual meeting income will be 
important as expenses increase each year.
Dr. Smith suggested that CANS should do something with the money held in the money market 
account for CAPP.  Since federal medical malpractice is sure to become an important issue next year, 
the Board should consider contributing money to the malpractice initiative.  The Board agreed that 
$1500 would be contributed.

6.         2004 Annual Meeting
Dr. Rich reviewed the program he has planned for the joint socio-economic session.  Speakers will be 
Dr. Richard Anderson of the Doctors Company (medical malpractice) and three speakers on
Medicare (John Nelson, M.D. of the AMA, Richard Taw of the American Private Physicians Association and 
Barry Straube, M.D. of the Centers for Medicare and Medicaid).  The CANS Business Meeting will 
include Katie Orrico of the Washington Committee, Dr. Smith (AANS /CME and Recertification) and 
Dr. Florin (Workers’ Comp update).  There will also be a 5-CME hour Fluoroscopy session and an alternate session presented by the ACN on traumatic brain injury. The grant request letter will be resent to the Board members so they can
follow up on local contacts.  

7.   
Liaison with ACN
The issue on whether to continue holding a joint annual meeting with the Association of California 
Neurologists (ACN) will be discussed further at the joint Executive Board Meeting (CANS and ACN) 
on Friday, January 17, 2004 in Newport Beach. 

8.         Letter of Reference for Dr. Rogan
The Board agreed that a letter of reference for Dr. Gerald Rogan, former Executive Director of 
National Heritage Insurance Company (NHIC) would be sent.  

9.         CMA Committee Nominations
The Board will submit the names of the following candidates for various 2004 CMA committees:
Re-appointments
Robert Meredith, MD                Council on Ethical Affairs
Robert Meredith, MD                Committee on Workers’ Compensation
Patrick Wade, MD                    Committee on Professional Liability
Spiros Koulouris , MD                 Committee on Medical Services

New appointments
Moustapha Abou-Samra , MD     Council on Ethical Affairs
Spiros Koulouris , MD                 Sub-committee on Physicians’ Confidential Line
Spiros Koulouris , MD                 Committee on Quality Care

10.    Blue Shield/IDET
Blue Shield of California has requested that CANS review its current position statement on 
Intradiscal Radiofrequency Thermocoagulation (IDET) and that CANS send a representative to its October 8, 2003 Technology Assessment Forum.  The Board’s position has not changed; CANS does not endorse IDET as an accepted treatment for back pain due to lack of conclusive scientific evidence of its efficacy. No one was able to attend the Blue Shield meeting.

11.       HIPAA
CMA has information available for members who have not met the requirement for HIPAA 
compliance. No action required.

12.       MBC
Dr. Lippe attended the recent meeting of the Medical Board of California (MBC). Dr. Rich reviewed 
the report summary prepared by Dr. Lippe stating that from 1993-2002, there were 120,000 practicing 
physicians in
California and only 1.3% of them settled 2 or more claims. 

13.       Workers’ Compensation
Dr. Florin reported on the current situation of Workers’ Comp which is still being discussed in the 
Legislature. The best prediction is that there will be a five billion dollar cut. He thinks that the 
decision will be to use the OMFS and take a straight % cut across the board, at 5 or 10 percent; caps 
on physical therapy and chiropractic visits; fee schedule of 120% of Medicare for outpatient surgery 
centers; and a MediCal-type fee schedule for drugs.  The Conference Committee is supposed to vote 
next week and legislation signed.  Dr. Florin advised that the Board take a wait-and-see approach. 
guidelines that the CMA House of Delegates approved earlier this year. Those guidelines indicated 
that the CMA would oppose the use of a resource-based fee schedule in the Workers’ Comp system. 
Dr. Florin, along with representatives from the Association of California Neurologists and the 
California Orthopaedic Association initially developed the idea of a California Relative Value Update 
Committee (CA-RUC) months ago when they were first involved with the project to update the 
OMFS.  This idea was not accepted by the CMA so perhaps some type of group should be formed 
outside of CMA which is mainly focused on primary care medicine which comprises the broadest 
number of physicians in their organization.  A motion was made and seconded to form a “Coalition 
for Fairness in Workers’ Compensation in
California .” This coalition should include the 7 groups 
who have endorsed a multiple conversion factor plan and the preservation of current fee levels for all 
codes and specialties:
California Association of Neurological Surgeons,  Association of California Neurologists
California Orthopedic Association, California Society of Industrial Medicine and Surgery,  California Radiological
Society,
California Society of Anesthesiologists, California Society of Physical Medicine and Rehabilitation

14.       Next Board Meeting 
The next Board of Directors meeting will be held Friday, January 16, 2004 in Newport Beach from 1:00-6:00 p.m.

JMT 

 

to home page